Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis

Peter-Horby

In a paper published in The Lancet this week (12th October 2017), Professor Peter Horby outlines potential epidemics in Africa.

It is difficult to predict when and where new epidemics might occur so we can be better prepared and have a proactive response. This modelling is based on information on each virus as well as governance, communication, infrastructure and health care provision. Some areas remain at high risk and would benefit from improved surveillance, diagnostic capabilities and better health systems and local policies.

Overview

We are all more aware of epidemics than we were a few years ago, we have all heard about Ebola and Zika viruses. It is however difficult to predict where and when new epidemics, caused either by known or new pathogens might occur so we can be better prepared for their emergence and have a proactive rather than reactive response to these diseases. The current collaborative work performed by the University of Oxford and others uses experimental models to explore the potential of four known viral haemorrhagic diseases with pandemic potential in Africa (Ebola virus, Crimean-Congo haemorrhagic fever, Lassa fever and Marburg virus).

The modelling was performed in three stages looking at the likelihood that i) one person will become infected ii) this will spread within their community (quantifying outbreak potential) and iii) the potential that the infection will spread nationally, regionally and internationally. The model was based on pertinent information about each virus (i) and local information such as the governance, communication, infrastructure and health care provision (ii) together with flight information to and from the area (iii).

The work found that areas within Africa have a differing potential for an epidemic to occur, with regions which have previously been affected by past outbreaks having a high potential (e.g. Western Africa) and those currently thought not to be at high risk (e.g. Cameroon and Ethiopia) being at risk. This work identifies areas which would benefit from improved surveillance, diagnostic capabilities and health systems together with the appropriate local policies. Understanding where these outbreaks are likely to happen are paramount in order to design protocols and prevent future outbreaks.